Individual
DR. ELIZABETH CIFUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-2000
Mailing address
1515 N MYRTLEWOOD ST, PHILADELPHIA, PA 19121-3633
(484) 680-3938
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MT228090
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT228090
GRADUATE MEDICAL TRAINEE LICENSE
PA
Enumeration date
05/16/2023
Last updated
05/16/2023
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